A Nova Scotia paramedic accused of sexually assaulting a 71-year-old woman in his care started his trial in Windsor provincial court on Monday.

James Duncan Keats is accused of two alleged sexual assaults against the woman. She said she was assaulted twice by Keats while she was his patient, once in September 2012 and again in May 2013.

Keats has been suspended as a paramedic until the outcome of his legal case.

The woman told court on Monday that ambulances were called to her home at least two or three times a week because of health problems suffered by both her and her husband. She said first responders were at her house so often they were "almost like family."

The woman, whose identity is protected by a publication ban, testified that on the day of the first alleged assault, an ambulance was called when her husband fell and couldn't get up.

She said a "large paramedic with sandy hair and glasses" was one of two paramedics who responded to her home.

She suffered chest pains while paramedics worked on her husband and testified she was taken upstairs to the bedroom to be examined.

She told the court the larger man took her up to her room, removed her house dress and proceeded to fondle her, perform oral sex on her and then rape her.

The woman testified she didn't scream because she was afraid the other paramedic might join in the assault.

The woman said on the second occasion, the same large paramedic stripped her and groped her as she was riding in an ambulance on her way to the hospital.

The woman said she wanted to kill herself after the assaults, but realized that was not the way to think and went to see her doctor instead. A couple of days later she called police, saying she didn't want what happened to her to happen to anyone else.

Bill Fergusson, the Crown prosecutor, praised the woman for being steady on the stand.

"She's doing the best she can," he said. "She's 71 years of age so I assume it's a very traumatic event in her life."

Keats stared straight at the woman as she testified and occasionally took notes on yellow legal pad.

At one point, the woman left the stand and walked around the courtroom, studying every man close up. After several seconds studying Keats she said it was "one like him."

The cross examination of the complainant took more than twice as long as direct examination by the Crown. Court ended its session for the day on Monday with the woman still on the stand.

Fergusson said it's not surprising.

"That's what defence lawyers like to do," he said. "They like to get their very exact detail and repeat it over and over again, hoping the answers start to change."

The case will resume on Friday.